How It Works

When given through an estrogen patch, vaginal ring, or skin cream or gel (transdermal estrogen), estrogen enters the bloodstream directly, without passing through the liver. The estrogen in pills must be processed by the liver before entering the bloodstream, which puts stress on an impaired liver.

Why It Is Used

Women in their 20s, 30s, and 40s who experience early menopause after having their ovaries removed (oophorectomy) or because of other medical reasons typically take ET to reduce their risk of early bone loss and osteoporosis. Historically, women have continued using ET for years beyond menopause. Some women now discontinue ET around the age of menopause.

Some of these side effects, such as headaches, nausea, fluid retention, weight gain, and breast tenderness, may go away after a few weeks of use.

The estrogen patch (transdermal estrogen) may cause skin irritation.

An estrogen ring must be replaced every 3 months. If the ring falls out at any time during the 3-month treatment period, you may rinse it with lukewarm water and reinsert it.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Risks of estrogen therapy

Estrogen therapy (ET) may increase the risk of health problems in a small number of women. This increase in risk depends on your age, your personal risk, and when ET is started.2 Talk with your doctor about these risks. Using ET may increase your risk of:

If you are taking ET after early menopause caused by a surgical hysterectomy, talk with your doctor about long-term ET risks and benefits.

Direct sunlight or high heat can increase, then decrease, the amount of hormone released from a patch. This can give you a big dose at the time and leave less hormone for the patch to release later in the week. Avoid direct sunlight on the hormone patch. Also avoid using a tanning bed, heating pad, electric blanket, hot tub, or sauna while you are using a hormone patch.

Citations

North American Menopause Society (2010). Estrogen and progestogen use in postmenopausal women: 2010 position statement of the North American Menopause Society. Menopause, 17(2): 242–255. Also available online: http://www.menopause.org/PSht10.pdf.

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